For patients, compliance with medical treatment regimens appears to be extremely difficult; according to the United States Food and Drug Administration (FDA), between 30 and 50 percent of patients fail to use medicines as prescribed (as described by Dixie Farley in “FDA Proposes Program to Give Patients Better Medication Information”, published in FDA Consumer magazine (November 1995)). The main problems with compliance include taking an incorrect dose, failing to take doses at the set time, missing doses and ceasing treatment prematurely, any one of which can, in the best case, prolong the recovery period, and in the worst case, result in a failure to treat the patient's condition at all.
A solution to this problem, which is advocated by the FDA, is for patients to keep a record of the names, doses, regimens of current medications; to discuss their treatment with a pharmacist or doctor regularly; and to follow the instructions given by these physicians. However, this approach relies on patients proactively monitoring and recording their medicament behaviour, and thus relies on the very aspect of human nature that, thus far, has made patient compliance so poor.
Several companies have been active in the development of medicament dispensers that record and store data indicative of medicament events, the data being subsequently downloaded to a centralised database for analysis by a physician. For example, U.S. patent application US2002/0104848 describes a system including a dispenser having a sensor adapted to sense opening of the dispenser cover (this being deemed indicative of dispensing of medicament) and a control unit adapted to store a time at which such an opening event has been detected. Data indicative of this event, which essentially provides a dispensing history, are stored on the dispenser and accessed by a base station, which communicates the data to a patient database for review by a physician. However, it is difficult for the patient to directly receive compliance information, since he has to rely on feedback from the physician. This means that the patient can only receive compliance information by consulting with his physician, which, to be successful, again relies on the patient making and keeping appointments.
In alternative systems, the dispensing device is arranged to display the times at which medicament have been dispensed on the device itself. For example, U.S. Pat. No. 5,642,731 describes a medicament dispenser having a sensor adapted to sense opening of the doors of the dispenser, a control unit adapted to store a time at which such an opening event has been sensed, and an electronic display having a menu from which the user can select one of a plurality of display options. One of these options corresponds to a review of the actual times that an opening event has been sensed (this being deemed indicative of dispensing of medicament) within a prescribed period (e.g. a number of hours or a number of days). The patent goes on to describe graphically displaying percentage compliance over time, together with symptom severity over time, recognising that patients are more likely to persevere with a treatment regimen if they can “see” their symptoms improving. However, displaying such information requires input from the user in relation to their symptoms, thus again relying on patients taking a proactive role in their treatment.
It would be desirable to provide a device that is of greater convenience to the user.